Tuesday, January 29, 2008

State of Health Care

It seems President Bush cares about as much for health care as he does New Orleansat least in the number of words, that is. In Bushs 2006 State of the Union speech, many in New Orleans believed he would outline many of his administrations plans for rebuilding the city and the Gulf Coast. Instead, Bush expended 160 words on all the feds had already done for New Orleans, and recognized that many of our fellow citizens have felt excluded from the promise of our country (they likely felt this exclusion most acutely when they were hanging out on rooftops waiting for days to be rescued, or while they were waiting for rescue for days at the Convention Center or it could have been when they were living for days, weeks and months in formaldehyde-laced trailer homes waiting for suitable replacement housing).

Even though 47 million Americans dont have health care insurance, no one really believed the president would talk too much about it in his 2008 State of the Union speech.

And the good news? Without any high expectations, no one was disappointed when Bush gave the nations health care all of 159 words. Besides, whats the point if youre only repeating yourself?

In 2007, the president introduced the idea of a $15,000 standard tax deduction for all families ($7500 for single people) that have health insurance, but for the first time, wage earners would also pay taxes on health insurance benefits they received from their employers.During that speech, Bush exclaimed that for those families paying for their own health insurance, his proposal would mean a substantial tax savings -- $4,500 for a family of four making $60,000 a year.What he didnt mention  maybe he hasnt priced health insurance in a while  was that most of the policies cost $5,000 to $7,000 (Im speaking from personal experience) per year with no real prescription drug coverage and extremely high deductibles (in our house, we referred to it as personal medical disaster insurance). His proposal never became law.

The president didnt elaborate as much this year about his plan, only that he intended to propose ending the bias in the tax code against those who do not get their health insurance through their employer. He didnt really bring up those families that dont have any insurance, nor that most of these families dont make $60,000 a year. By this point, though, he was on a roll, telling the audience this one reform would put private coverage within in the reach for millions  Brevity didnt allow him to prattle on about just exactly how many of the 47 million without health insurance coverage he was referring to.

The president then managed in one sentence to cover expanding health savings accounts, association health plans, health information technology and the evils of junk medical lawsuits. Then he went straight to his finale of we will help ensure that decisions about your medical care are made in the privacy of your doctors office  not in the halls of Congress.

What a finish. Unfortunately, he didnt really focus on what youre supposed to do when you cant afford a doctor. My guess is that you either keep feeling excluded like those folks in New Orleans, or you find someone else with more words and better ideas on health care to speak to the halls of Congress and address the state of the union in the years to come.